Perform prospective, concurrent and retrospective review of inpatient, outpatient, ambulatory and ancillary services to ensure medical necessity, appropriate length of stay, intensity of service and level of care, including appeal requests initiated by providers, facilities and members.
May establish care plans and coordinate care through the health care continuum including member outreach assessments.
Requested criteria:
Above average computer skills (Microsoft office).
Clinical experience in ICU, ER, or medical surgical unit preferred.
Prefer utilization management experience.
Resource will be able to perform this role offsite. May be required to come into the office for meetings and training.
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Summary • $5,000 Sign on bonus may be available for qualified candidates • • Competitive Wages • • Benefit package for eligible employees • • This position could also be filled by a LPN • • Under direct supervision of the provider, will be responsible for patient assessment and care, and maintaining...
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US - MI - MI - Lachine
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US - MI - MI - East Tawas
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US - MI - MI - Herron
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US - MI - MI - Auburn
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US - MI - MI - Sanford
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US - MI - MI - Tawas City
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US - MI - MI - Ann Arbor
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US - MI - MI - Sanford
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US - MI - MI - Sanford
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US - MI - MI - East Tawas
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US - MI - MI - Constantine
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